WQ0021204_Monitoring - 11-2016_20170104

NON DISCHARGE WASTEWATER MONITORING REPORT Page i of �-
PERMIT NUMBER: WQ0021204 MONTH: November YEAR: 2016
FACILITY NAME: North Chatham Vol. Fire Department COUNTY: Chatham
Point:!Flow Monitoring
MonitoringParameter -.
o ■ ■SW
Code/Name:
Was There Effluent Flow For This ..
o ■
..
Daily
(Flow) into
Treatment
System
MINNIE
NONNI
Daily Minimum
Monthly Limit(s)
Operator in Responsible Charge (ORC): Randall Jarrell Grade: IV Phone: [phone]
Check Box if ORC Has Changed: ❑ ORC Certification Number: 7937
Certified Laboratories (1): Wastewater Management, L.L.C. (2): ENCO Inc.
Person(s) Collecting Samples: Operators /1
Mail ORIGINAL and TWO COPIES to: �:`' ','d
DENR (SIGNATURE OF OPERATOWIN RESPONSIBLE CHARGE)
Division of Water Quality BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
ATTN: Information Processing Unit AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
1617 Mail Service Center
RALEIGH, NC 27699-1617
DENR FORM NDMR-1 (11/2005)

Page 2 of
NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
Compliant (Y,N)
1. Does all monitoring data and sampling frequencies meet permit requirements?
If the facility is non-compliant, please explain in the space below the reason(s) the facility was not in compliance
with its permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s)
taken. Attach additional sheets if necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that all qualified personnel properly gathered and
evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting
false information, including the possibility of fines and imprisonment for knowing violations."
i
(Signature of Permittee)* Date
Randall Jarrell
(Permittee -Please print or type)
45 Morris Road
Pittsboro, N.C. 27312
(Permittee Address)
Parameter Codes:
Randall Jarrell
(Name of Signing Official -Please print or type)
(Position or Title)
919-548-3099
(Phone Number)
ORC
01002 Arsenic
31504 Coliform, Total
00600 Nitrogen, Total
00929 Sodium
01022 Boron
00094 Conductivity
00630 NO2&NO3
00931 SAR
00310 BODS
01042 Copper
00620 NO3
00745 Sulfide
01027 Cadmium
00300 Dissolved Oxygen
00556 Oil -Grease
70295 TDS
00916 Calcium
31616 Fecal Coliform
WQ09 PAN (Plant Available)
00010 Temperature
00940 Chloride
01051 Lead
00400 pH
00625 TKN
50060 Chlorine, Total
Residual
00927 Magnesium
71900 Mercury
32730 Phenols
00665 Phosphorus, Total
00680 TOC
00530 TSSITSR
01034 Chromium
00610 NH3asN
00937 Potassium
00076 Turbidity
00340 COD
01067 Nickel
00545 Settleable Matter
01092 Zinc
1/31/2012
(Permit Exp. Date)
Parameter Code assistance may be obtained by calling the Water Quality Land Application Unit at [phone].
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use only the units designated in the reporting
facility's permit for reporting data.
* if signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28.0506 (b)(2)(D).
DENR FORM NDMR-1 (1112005)

NON -DISCHARGE APPLICATION REPORT Page > of
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: W00021204
MONTH: November YEAR: 2016
FACILITY NAME: North Chatham Vol. Fire Department COUNTY: Chatham
Formulas:
Daily Loading (inches) = [Volume Applied (gallons) x 0.1336 (cubic feet/gallon) x 12 (inches/foot)] /[Area Sprayed (acres) x 43,560 (square feet/acre)] OR
= Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/acre-Inch)]
Monthly Hourly Loading (inches) = maximum inches applied over a one hour period for that day
Monthly Loading (Inches) =Sum of Daily Loadings (inches)
12 Month Floating Total (inches) =Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
Average Weekly Loading (inches) = (Monthly Loading (inches/month) / Number of days in the month (days/month)] x 7 (daystweek)
Did Irrigation Occur At This Facility:
Yes: 0 No: ❑
Did Irrigation Occur On This Field:
Yes: ED No: ❑
Did Irrigation Occur On This Field:
Yes: ❑ No:
FIELD NUMBER: 1
AREA SPRAYED (acres): 0.15
COVER CROP: Grass
PERMITTED HOURLY RATE (inches): 0.3
FIELD NUMBER:
AREA SPRAYED (acres):
COVER CROP:
PERMITTED HOURLY RATE (inches):
WEATHER CONDITIONS
PERMITTED YEARLY RATE (inches):
25.4
PERMITTED YEARLY RATE (inches):
D
A
T
E
Storage
Temper- Lagoon
weather
Code, ature at Precipita- Free-
application tion board
Volume Time
Applied Irrigated
Maximum
Dail Hourly
Y Y
Loading Loading
Volume Time Dail Y
Applied Irrigated Loading
Maximum
Hourly
Y
Loading
rF) inches feet
gallons minutes
inches
inches
gallons minutes inches
inches
1
2
3
4
5
6
7
C 52 0.07
8
9
10
11
12
13
14
CL 47 0.19
310 24
0.08
0.19
15
16
17
18
19
20
21
C 36 0
310 24
0.08
0.19
22
23
24
25
26
27
28
CL 33 0
310 24
0.08
0.19
29
30
31
Tota[ Gallons/Monthly Loading (inches)
930
0.23
0 0.00
12 Month Floating Total (inches)
3.36
Average Weekly Loading (Inches)
0.0532437
0
Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet
Spray Irrigation Operator in Responsible Charge (ORC): Randall Jarrell Phone: [phone]
ORC Certification Number:
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
7937 Check Box if ORC Has Changed: ❑
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND
COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (11/2005)

NON -DISCHARGE APPLICATION REPORT Page iof
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the
compliant box. )
1. The did the limit(s) in the
Com �liant Y,N)
application rate(s) not exceed specified permit.
Ly
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit.
If the facility is non-compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations."
,1 JL,,�) Iz1241 �
(Signature of Perrr)ittee)* Date
Randall Jarrell
(Permittee -Please print or type)
45 Morris Road
Pittsboro, N.C. 27312
(Permittee Address)
Randall Jarrell
(Name of Signing Official -Please print or type)
ORC
(Position or Title)
919-548-3099 1/31/2012
(Phone Number) (Permit Exp. Date)
* If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 26.0506 (b)(2)(D).
DENR FORM NDAR-1 (11/2005)

NCVFD
12 Month Rolling Total Application In Inches
2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2015 2016
Field Jan Feb March April May June July August Sept Oct Nov Dec Total
1 0.3 0.52 0.37 0.22 0.45 0.22 0.3 0.3 0.15 0.37 0.23 0.45 3.36